Path of Physical Exercise's Impact on Deviant Behavior Among Chinese Adolescents.

Purpose: Physical exercise is an important predictor of deviant behavior in adolescents; however, the paths and mechanisms underlying this relationship remain understudied. Patients and Methods: This cross-sectional study used education tracking data of 8725 Chinese adolescents (4453 males, 4240 females, average age 14 ± 0.73) to construct a chain mediation model to explore whether sleep quality and mental health mediated the relationship between physical exercise and adolescent deviant behavior. Results: The results show that physical exercise cannot directly predict adolescent deviant behavior; however, it can indirectly affect deviant behavior through the mediating effect of sleep quality and mental health as well as the chain mediating benefit of "sleep quality-mental health". Conclusion: Sleep quality and mental health are important internal factors of physical exercise that inhibit deviant adolescent behavior. The lack of physical activity and poor sleep quality should be prioritized in interventions regarding deviant behavior among Chinese adolescents.

The influence of axillary surgery and radiotherapeutic strategy on the risk of lymphedema and upper extremity dysfunction in early breast cancer patients.

PURPOSE: To explore the risk factors for breast cancer-related lymphedema (BCRL) and upper extremity dysfunction (UED) in patients with early breast cancer after modern comprehensive treatment and to compare the toxicity of different treatment strategies. METHODS: From 2017 to 2020, a total of 1369 female patients with pT1-3N0-1M0 breast cancer who underwent adjuvant radiotherapy in our centre were retrospectively reviewed. BCRL and UED were identified by the Norman and QuickDASH questionnaires. The incidence, severity and risk factors for BCRL and UED were evaluated. RESULTS: After a median follow-up of 25 months, a total of 249 patients developed BCRL; axillary lymph node dissection (ALND), increased number of dissected nodes, right-sided and hypofractionated radiotherapy containing RNI were found to be significant risk factors (all p values < 0.05). The sentinel lymph node biopsy (SLNB)+ regional nodal irradiation (RNI) group had a significantly lower BCRL risk than the ALND + RNI group (10.8% vs. 32.5%, HR = 0.426, p = 0.020), while there was no significant difference between ALND vs. ALND + RNI or SLNB vs. SLNB + RNI. A total of 193 patients developed UED, and ALND (p = 0.02) was the only significant risk factor. The SLNB + RNI group had a significantly decreased risk of UED compared with the ALND + RNI group (7.5% vs. 23.9%, HR = 0.260, p = 0.001), and there was no significant difference between SLNB vs. SLNB + RNI or ALND vs. ALND + RNI. CONCLUSION: Aggressive ALND remains the primary risk factor for BCRL and UED while RNI does not. Thus, replacing ALND with tailored radiotherapy would be an effective preventive strategy in early breast cancer patients.

Weight self-stigma and engagement among obese students in a physical education class.

Background: This is a cross-sectional in design. It involves the mediating effects of basic psychological need satisfaction in relation to the moderating effects of teacher autonomy support regarding weight self-stigma's effect on engagement among obese students in physical education classes. Methods: This study includes 165 Chinese high school obese students [mean age, 16.84 (±0.147) years], comprising 93 males (56.63%) and 72 females (43.63%), with a mean body mass index (BMI) of 30.453 (SD = 2.426). Participants completed the weight self-stigma questionnaire, basic psychological need satisfaction questionnaire, teacher autonomy support questionnaire, and student engagement questionnaire. Results: Weight self-stigma and engagement among obese students were mediated by basic psychological need satisfaction. Moreover, the mediated effect of basic psychological need satisfaction was moderated by teacher autonomy support. Conclusion: Weight self-stigma and basic psychological need satisfaction are the antecedents influencing the engagement of obese students. Notably, weight self-stigma not only directly blocks the engagement of obese students but also their engagement by hindering the acquisition of basic psychological need satisfaction. Teacher autonomy support can significantly reduce the negative impact of weight self-stigma on basic psychological need satisfaction and significantly promote engagement. Therefore, by promoting their physical education engagement, physical education teachers should strengthen the application of their supportive autonomous teaching strategies to help obese students meet their basic psychological needs.

Perceived teacher's support and engagement among students with obesity in physical education: The mediating role of basic psychological needs and autonomous motivation.

Grounded in self-determination theory, this cross-sectional study aims to explore the multiple mediating roles of perceived teachers' support for students with obesity and their engagement in physical education. The study included 322 Chinese high school students with obesity (mean age, 16.84 [±0.147] years; 219 [68%] male, 103 [32%] female). Mplus 8.3 software was used to test the multiple mediating effects. After controlling for grade and gender, teacher support was found to neither directly affect students' engagement nor directly stimulate their autonomous motivation; however, it could affect their engagement through the two pathways of 1) basic psychological needs and 2) the chain mediation of basic psychological needs and autonomous motivation. Results suggest that not all teacher support, but only teacher support meeting students' basic psychological needs, can promote engagement in PE by students with obesity. Future research should explore strategies according to the physical and mental characteristics of students with obesity, to enrich and innovate the theoretical system of teacher support in physical education. Furthermore, teacher support interventions to promote engagement among students with obesity should be developed.

Nonpharmacological Interventions for Sleep Promotion on Preterm Infants in Neonatal Intensive Care Unit: A Systematic Review.

BACKGROUND: Nonpharmacological interventions are often used to promote sleep among preterm infants in the neonatal intensive care unit (NICU). However, there is a lack of synthesis in the evidence of their effectiveness. AIM: To synthesize the evidence on the effectiveness of nonpharmacological interventions on NICU preterm infants' sleep during hospital stay. METHODS: Seven databases were searched, including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Wan-fang database, China National Knowledge Infrastructure, China Biological Medicine Database, and VIP Journal Integration Platform from their inceptions to August 2017. Randomized controlled trials examining the effects of nonpharmacological interventions on preterm infants' sleep were included. RESULTS: This review included 36 studies. Nonpharmacological interventions included the Newborn Individualized Developmental Care and Assessment Program (NIDCAP), music, non-nutritive sucking, touch, cycled light, cobedding, rocking, oral sucrose, remolding mattresses, and family nurturing. The meta-analysis results showed that 1. the NIDCAP had no significant effect on total sleep time efficiency (TST%; p = .34); 2. mattress interventions had significant effects on TST% (p < .001); and active sleep efficiency (AS%; p = .006) but no significant effect on quiet sleep efficiency (QS%; p = .75); 3. cycled light increased TST (p = .02); and 4. cobedding had no significant effects on QS% and AS% (p = .63 and p = .88, respectively). LINKING EVIDENCE TO ACTION: Remolding mattresses and cycled light had significant effects on sleep promotion in preterm infants, but the quality of the evidence was very low. Further high-quality studies are needed to strengthen this evidence.

Fathers' feelings related to their partners' childbirth and views on their presence during labour and childbirth: A descriptive quantitative study.

This study examined Chinese fathers' feelings about their partners' delivery and views on their presence during labour and birth. A questionnaire survey was conducted with 403 fathers whose partners gave birth in one provincial hospital in China. Data were analysed by descriptive statistics, χ(2)-test and content analysis. The results indicated that more than 80% of fathers experienced feelings of pride related to fatherhood and of love towards their partners and newborns. Significant differences in fathers' feelings were found between subgroups with regard to age, education, employment, presence in the delivery room, method of birth and whether preparatory visits had been made to the hospital. The majority who answered an open-ended question on the meaning of fathers' presence in the delivery room held a positive attitude towards fathers' presence at labour and birth, as their presence could empower their partners and provide psychological support. This study indicates fathers' presence at delivery and birth is important and that younger fathers need more support. It also provides evidence for clinical practice and future interventions to improve fathers' psychological health and experiences.